THE EFFECT OF LORNOXICAM ON THE SYSTEMIC INFLAMMATORY RESPONSE IN PATIENTS WITH ACUTE PANCREATITIS. CLINICAL RANDOMIZED TRIAL
https://doi.org/10.38181/issn2223-2427.2019.4.32-39
Abstract
Abstract: the trigger pathogenetic mechanism of local and systemic inflammatory changes in acute pancreatitis is the production of inflammatory mediators and, in particular, cytokines. It determines the positioning of the systemic inflammatory response as a target for therapeutic action.
The aim of research: evaluation of the analgesic effect of lornoxicam therapy, as well as studying the effect of the drug on the systemic inflammatory response in patients with acute pancreatitis.
Materials and methods: the randomized prospective study included 334 patients with acute pancreatitis aged 25 to 68 years. The patients were divided into two groups. Patients in group 1 (n = 246) were treated only with standard conservative OP therapy; 88 patients in group 2 were additionally treated with lornoxicam. The severity of the pain syndrome and the frequency of postoperative complications were evaluated.
Results: In the second group of patients, systemic complications developed statistically significantly less frequently (p = 0.00034), and mortality was also statistically significantly less (p = 0.006). In group 1 patients, on the third day of the inpatient period, there is an increase in the level of proinflammatory cytokine production, while in group 2 patients, cytokine secretion decreases statistically significantly.
Conclusion: the inclusion of lornoxicam therapy to the complex of conservative measures in patients with acute pancreatitis allowed to reduce not only the intensity of the pain syndrome, but also the frequency of complications of pancreatogenic toxemia and to reduce mortality in this category of patients.
About the Authors
E. A. Galliamov
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Galliamov Eduard Abdulhaevich – MD, Professor, Head of the General Sur-gery Department
Bolshaya Pirogovskaya St., 19/1, 119146, Moscow
M. A. Agapov
Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)
Russian Federation
Russian Federation
Agapov Mihail Andreevich – MD, Professor of the Department of Surgery
Leninskie Gory St., 1, 119991, Moscow
P. S. Malahov
Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)
Russian Federation
Russian Federation
Malahov Pavel Sergeevich – head of the Department of intensive care and anesthesiology of medical research and education center
Leninskie Gory St., 1, 119991, Moscow
V. V. Kakotkin
Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)
Russian Federation
Russian Federation
Kakotkin Viktor Viktorovich – Resident of the Department of Surgery of the Faculty of Medicine
Leninskie Gory St., 1, 119991, Moscow
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Review
For citations:
Galliamov E.A., Agapov M.A., Malahov P.S., Kakotkin V.V. THE EFFECT OF LORNOXICAM ON THE SYSTEMIC INFLAMMATORY RESPONSE IN PATIENTS WITH ACUTE PANCREATITIS. CLINICAL RANDOMIZED TRIAL. Surgical practice (Russia). 2019;(4):32-39. (In Russ.) https://doi.org/10.38181/issn2223-2427.2019.4.32-39
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